Organization
HEARTLAND NEUROLOGY ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THEODORE A NUKES M.D. (PRESIDENT)
(317) 249-0990
Entity
Organization
Contact information
Practice address
1185 W CARMEL DR, STE D-3, CARMEL, IN 46032-8708
(317) 249-0990
(317) 249-0999
Mailing address
1185 W CARMEL DR, STE D-3, CARMEL, IN 46032-8708
(317) 249-0990
(317) 249-0999
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12948050
DEPT OF LABOR
IN
05
—
200088510A
—
IN
01
—
CC3453
RR MEDICARE
IN
01
—
I021587
CHAMPUS
—
Enumeration date
05/18/2006
Last updated
09/06/2012
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